Cardiovascular disease remains the number one cause of death in developed countries. Furthermore, incidence of cardiovascular disease has increased dramatically in developing countries. Although cardiovascular disease usually affects older adults, the antecedents of cardiovascular disease, notably atherosclerosis, begin in early life, making primary prevention efforts necessary from childhood. It is estimated that 1 in 3 people will die from complications attributable to cardiovascular disease. “Global Atlas on Cardiovascular Disease Prevention and Control”, World Health Organization; January 2012. In order to stem the tide and address the shifting epidemiology of this disease, measures to prevent or reverse cardiovascular disease must be taken.
Obesity and diabetes mellitus are often linked to cardiovascular disease, due to increased atherosclerosis and direct effects on the heart, as are a history of chronic kidney disease and hypercholesterolemia. In fact, cardiovascular disease is the most life threatening of the diabetic complications and diabetics are two- to four-fold more likely to die of cardiovascular-related causes than nondiabetics.
Diet and exercise, even when used in conjunction with the current pharmacotherapy, often do not provide sufficient control of cardiovascular symptoms. The continuing and highly prevalent problem of cardiovascular disease highlights the overwhelming need for new drugs to treat this condition and its underlying causes. Among these conditions is heart failure, for which there continues to be a need for better therapy as hospitalized patients have poor outcomes as their conditions progresses following discharge (Butler, J, Braunwald, E. and Gheorghiade, M. “Recognizing Worsening Chronic Heart Failure as an Entity and an End Point in Clinical Trials” (2014) JAMA 312:789-790)